Hcr220 Week Six Checkpoint- Applying Level Ii Hcpcs Modifiers
HCR/220–Week Six Checkpoint–Applying Level II HCPCS Modifiers * Apply the appropriate Level II HCPCS code modifier for each of the following examples. Explain your rationale.
a) Portable home oxygen unit-GY – identifies rental or purchase of durable medical equipment for use in the patient’s home; is statutorily excluded, does not meet the definition of any Medicare benefit or for non-Medicare insurers, is not a contract benefit, is appended to procedures that are excluded from the Medicare payment system. b) Left trigger thumb release–FA- left hand, thumb- Modifiers used in conjunction with the procedures of the hand, feet, and eyelids. The modifiers will not affect payment amount; however, failure to use these modifiers when appropriate, could result in claim delay or denial. c) Incision and drainage of abscess involving right fourth toe-T8-Right foot, fourth digit- Modifiers used in conjunction with the procedures of the hand, feet, and eyelids. The modifiers will not affect payment amount; however, failure to use these modifiers when appropriate, could result in claim delay or denial. d) Emergency ambulance transport and extended life support-QN-Ambulance service furnished directly by a provider of services. Since the service is provided directly by the service provider and not a doctor or facility this modifier would apply in which extended life support would be included. An ABN modifier could possibly be added but not on the given list of modifiers. e) Lesion removed from the right breast-RT- Right side of the body- used to identify procedures performed on the right side of the body. Applies to code that identify procedures which can be performed on a contralateral anatomic sites or on paired organs, extremities on e.g., ears, eyes, nasal passages, kidneys, lungs, ureters, and ovaries. f) Total microscopic examination of an ovary- RT-Right side of the body- used to identify procedures performed on the right side of the body.
a) Portable home oxygen unit-GY – identifies rental or purchase of durable medical equipment for use in the patient’s home; is statutorily excluded, does not meet the definition of any Medicare benefit or for non-Medicare insurers, is not a contract benefit, is appended to procedures that are excluded from the Medicare payment system. b) Left trigger thumb release–FA- left hand, thumb- Modifiers used in conjunction with the procedures of the hand, feet, and eyelids. The modifiers will not affect payment amount; however, failure to use these modifiers when appropriate, could result in claim delay or denial. c) Incision and drainage of abscess involving right fourth toe-T8-Right foot, fourth digit- Modifiers used in conjunction with the procedures of the hand, feet, and eyelids. The modifiers will not affect payment amount; however, failure to use these modifiers when appropriate, could result in claim delay or denial. d) Emergency ambulance transport and extended life support-QN-Ambulance service furnished directly by a provider of services. Since the service is provided directly by the service provider and not a doctor or facility this modifier would apply in which extended life support would be included. An ABN modifier could possibly be added but not on the given list of modifiers. e) Lesion removed from the right breast-RT- Right side of the body- used to identify procedures performed on the right side of the body. Applies to code that identify procedures which can be performed on a contralateral anatomic sites or on paired organs, extremities on e.g., ears, eyes, nasal passages, kidneys, lungs, ureters, and ovaries. f) Total microscopic examination of an ovary- RT-Right side of the body- used to identify procedures performed on the right side of the body.